Video Cards are rather easy to replace, and yes they do go out. More than likely, unless you installed one you have been running off the motherboard graphics card. Which, in most cases, is not a very good card.
You will need to know a few things about your motherboard before you can buy one. Shut down the tower and unplug the power cable. Open the side (there should be two screws in the back that release the side panel) and then try and see if you can figure out the model number of your motherboard. If you have your owner's manual, that would be best. You will need to know what type of slot(s) you have available. If you get the wrong one, it won't plug in. When I got mine I just took my owner's manual for the motherboard to the tech store and the guy showed me exactly which one I needed. If you can't find the model number of the motherboard or the owner's manual, you should bring the tower to the tech store and ask them 'which video card do I need'. They will be able to look at the motherboard and tell you exactly which one will fit in your tower.
Also, have you upgraded your RAM at all. Large graphics eat up a lot of memory and maybe your pc doesn't have enough RAM to process these images without conflict. With the XP OS I would run no less that 3 GB of RAM if your motherboard will allow it. You can go as high as 4 GB with XP, but it will only recognize 3.25 GB. If you only have two RAM slots, I would personally get two 2 GB cards, but that's me. You will also need information on your motherboard to know which speed of RAM is most compatible with your motherboard.
From there, it is very simple. You insert the VC in the slot, screw it into place on the back of the tower, put the side panel back on, move your monitor cable to the new VC, power up the tower. I recommend you install the drivers from the CD and immediately do a driver update. The CD that comes with the VC may not have the most up to date drivers. After that, go to microsoft updates and see if XP needs any updates for the new VC drivers. After that, you should be good to go.